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Re: Breastfeeding twins, how else can I increase production?

Originally Posted by @llli*djs.mom

You breast are never actually out of milk. And that is why the week end long nurse in is the best option. Even if your babies are showing signs of frustration. Because they have learned by being continually supplemented that they only have to work through a letdown. And that as soon as they fuss you will give them food an easier way. Which a bottle absolutely is. So I imagine it is actually affecting your supply because the less work they are willing to do at the breast, the less you will produce. Crying isn't the end of the world. Especially since you are right there with them. Their frustration is part of their routine. They fuss, you give them a bottle. If you don't give them a bottle what is the alternative? When you are there and they can smell your milk? To get hungry enough to do the work. We are creatures of comfort, but we are also mammals that are hard wired to survive. If they understand that the "easier way" isn't coming, they will eventually do the work. Which they will have plenty of opportunity to do if they are in bed skin to skin with you all day long. Try it again. And prepare for some crying. And some refusal. But if you aren't getting up to pump, and the boobs is all there is, eventually they will eat. You may very well have a rough first few hours. Tough it out. Because what you are trying to do is get them to FORGET about the easier way to eat. Eventually their instincts will kick in and they will suck.

Ok, these words are just too wise to not try it again (I was going to anyways). I'll refer back to this post as I'm crying with the babies in bed tomorrow. :P

Last edited by @llli*twincon; June 21st, 2012 at 09:01 PM.
Reason: reply meant for djs.mom

Re: Breastfeeding twins, how else can I increase production?

Originally Posted by @llli*mommal

:

How much milk do you put in the supplemental bottles? If you are unable to be as tough as suggested above, you could try giving a very small supplement- say 1 oz or 1/2 oz- and then return the babies to the breast for more nursing. The "finish at the breast" technique can be helpful with babies who think that every feeding concludes with a bottle. If they learn that every feeding begins and ends at the breast, they may eventually forget to fuss for a bottle. The breast is a much nicer place to get your comfort sucking done than a bottle, after all!

The supplemental bottles are anywhere from 8oz to 4 oz. I cluster pump at night for about 4 or 5 hours and that will give me at most 6 or 7 oz. Then I pump in the morning after their 7 o'clock nursing and when they are taking their "vitamin milk" (which I put the vitamin in formula milk of 2 oz so I don't waste any breast milk when/if they are being finicky). Then I pump at the end of most every nursing and I will only get 3-5ml from each breast for that. The supplemental pumped breast milk bottle will last them from their 10a, 12p, 2p and 4p nursings (each baby maybe taking about 1-2oz each from the bottle, sometimes they won't take any) and then by their 6pm feeding (when I put them to sleep), they will nurse and that's when I make a formula bottle.

Re: Breastfeeding twins, how else can I increase production?

Remember without the formula, your babies are going to want to eat way more often. Another reason the nurse in, in your bed for 2 days is the best idea. Since you are not used to feeding on real
demand if you were trying to have a normal day this could get very overwhelming since you aren't really used to it. But if you go into it thinking "All I am going to do all day is NURSE, eat and sleep" and that is all you do, it won't be so overwhelming. The supplements are at the root of ALL of your problems. Because they affect your supply two fold each time you use them at least. And reading your schedule it's really clear that that is what is happening. Because in the morning when you use formula, you body is missing that que entirely, PLUS formula is harder on their system and it takes longer to digest. So instead of demanding food again in an hour or an hour and a half they probably are waiting 2-4 hours to demand again. And that space out in demand is happening EVERY TIME you use formula even if you are only topping off. So mentally prepare for the fact that one you get over the crying in the morning, that they will be on you pretty much all day. And that is what you want. You want the demand for breastmilk to GO UP so you MAKE MORE. Which you naturally WILL when they don't have undigested formula sitting in their tummies for hours. Become one with the babies. Do breast compressions when they seem frustrated and just imagine you and your kids are on a dessert island and this is ALL THERE IS. Could you keep them alive? You could! You know how? By breastfeeding them. Non-stop. Even if you had nothing to eat. Even as you were getting dehydrated. Your body would protect and make milk for those kids. TRUST THAT. And you will be able to do it Mama. Stay Focused. And Good luck.

Re: Breastfeeding twins, how else can I increase production?

Originally Posted by @llli*djs.mom

Remember without the formula, your babies are going to want to eat way more often. Another reason the nurse in, in your bed for 2 days is the best idea. Since you are not used to feeding on real
demand if you were trying to have a normal day this could get very overwhelming since you aren't really used to it. But if you go into it thinking "All I am going to do all day is NURSE, eat and sleep" and that is all you do, it won't be so overwhelming. The supplements are at the root of ALL of your problems. Because they affect your supply two fold each time you use them at least. And reading your schedule it's really clear that that is what is happening. Because in the morning when you use formula, you body is missing that que entirely, PLUS formula is harder on their system and it takes longer to digest. So instead of demanding food again in an hour or an hour and a half they probably are waiting 2-4 hours to demand again. And that space out in demand is happening EVERY TIME you use formula even if you are only topping off. So mentally prepare for the fact that one you get over the crying in the morning, that they will be on you pretty much all day. And that is what you want. You want the demand for breastmilk to GO UP so you MAKE MORE. Which you naturally WILL when they don't have undigested formula sitting in their tummies for hours. Become one with the babies. Do breast compressions when they seem frustrated and just imagine you and your kids are on a dessert island and this is ALL THERE IS. Could you keep them alive? You could! You know how? By breastfeeding them. Non-stop. Even if you had nothing to eat. Even as you were getting dehydrated. Your body would protect and make milk for those kids. TRUST THAT. And you will be able to do it Mama. Stay Focused. And Good luck.

Wow, thanks so much djs.mom, you are very encouraging! Today was day 1 of the no bottles and breastfeeding on demand day. I am still not very confident in myself that I made enough for them, but there were wet diapers (not as wet as usually are) but SO SOSO much crabbiness and crying! Everytime they would cry, I would diligently put them to breast, but once my let down was done or if none was coming - they both would freak out and refuse the breast completely and get even angrier when I tried to re-latch them over and over again. So, I would take them off and try again in a few minutes after I diverted their attention with whatever. Once they were put back on though, they still freaked out. I didn't try to express while they were on though - so I will try this next time (I'll have to read up on how to do this again).
My question of the day: I've been told that your breast needs to be empty for your body to know to make more milk. Today, the babies were put to breast as much as I think they wanted/needed (which was maybe every hour at the least of actual suckling). I'm pretty sure that they didn't have the patience to stick around for more than 2 let downs (and really started crying after the first let down stopped). I would try them again later once they started getting fussy. SO, if they are not completely emptying the breast, how does my body know to make more? I'm sure it was stimulated more (although, it was pretty stimulated in my old routine of letting them nurse, then pumping afterward to ensure it was empty + the cluster pumping at night?!), but I have no idea if it was being emptied by them? I'm hoping this will only take a couple more days and they can learn to be patient babies and suck harder/more efficiently, but if they aren't emptying my breast, I hope this doesn't hurt me?

Also, I made an appt. with my Gyno for a thyroid test (just to be sure), she also said I could be put on Reglan to increase my milk production if I want. I am SO against medications and really truely want to this the natural way if my body can do it - but do you know of any pros or cons of this medication? I would think I'd go herbal before the medicine route though.

Re: Breastfeeding twins, how else can I increase production?

Today was day 1 of the no bottles and breastfeeding on demand day. I am still not very confident in myself that I made enough for them, but there were wet diapers (not as wet as usually are)...

Good for you! This means you can do it! The milk is there, they just need to learn how to work for it. If you stick this out, then bottles will be a thing of the past!

...but SO SOSO much crabbiness and crying! Everytime they would cry, I would diligently put them to breast, but once my let down was done or if none was coming - they both would freak out and refuse the breast completely and get even angrier when I tried to re-latch them over and over again. So, I would take them off and try again in a few minutes after I diverted their attention with whatever. Once they were put back on though, they still freaked out.

This isn't all that uncommon. There is a learning curve for both mamas and babies when it comes to breastfeeding. My son did a lot of screaming at the breast (some of which was due to a fast letdown, but some of which was due to the flow slowing down after the letdown. Make up your mind kid. Breastfeeding is pretty stressful early on. I truly hated it for many weeks. But if you just keep putting your babies to the breast and resist the urge to use bottles, it will get easier. Way, way, way easier. Even though there is a large initial investment, breastfeeding ends up being a billion times easier than bottles once you and your babies find your groove.

My question of the day: I've been told that your breast needs to be empty for your body to know to make more milk. Today, the babies were put to breast as much as I think they wanted/needed (which was maybe every hour at the least of actual suckling). I'm pretty sure that they didn't have the patience to stick around for more than 2 let downs (and really started crying after the first let down stopped). I would try them again later once they started getting fussy. SO, if they are not completely emptying the breast, how does my body know to make more? I'm sure it was stimulated more (although, it was pretty stimulated in my old routine of letting them nurse, then pumping afterward to ensure it was empty + the cluster pumping at night?!), but I have no idea if it was being emptied by them? I'm hoping this will only take a couple more days and they can learn to be patient babies and suck harder/more efficiently, but if they aren't emptying my breast, I hope this doesn't hurt me?

I think as long as you are getting the stimulation, then your body will get the message. Your babies are wetting diapers, which means they are getting milk which means the breast is being emptied (although perhaps not as much as previously). I wouldn't worry about it. Babies (even babies that fuss at the breast) are better than pumps at maintaining milk supply.

Re: Breastfeeding twins, how else can I increase production?

You can never truly empty the breast. Milk is always being made. A fuller breast makes milk relatively slowly, an emptier breast makes it very quickly- but nevertheless, milk is always being made. I think you are taking the right approach here, but if you feel like your babies are having difficulty emptying the breast or if you see wet diaper output drop below what it should be, then it's time to reassess this strategy and return to what you were doing before. I don't think you are going to need to do that, though!

I took Reglan when I was having trouble nursing my first daughter. It can increase serum Prolactin and thereby increase milk supply, but it is not FDA-approved for that purpose. It has additional side-effects, including (IIRC) the potential to cause dizziness, tiredness and depression. There is new information suggesting that long-term use can cause dyskinesias, but my understanding is that dyskenesias are a risk only if someone takes it for a period of years. Reglan can definitely help increase supply, but if your babies are nursing well you don't need it. And if you can fit pumping in on top of nursing, then that's another reason why you may not need it: increased stimulation and more complete emptying of the breast is even better, in my experience, than any drug or supplement.

Re: Breastfeeding twins, how else can I increase production?

Keep at it Today mama! None of us love our job on the 1st day. Your babies should do better today. And YOU DID IT. YOU MADE IT A WHOLE DAY WITHOUT SUPPLEMENTS!!! Right? That means YOU CAN DO IT.
Besides reglan there are other supplements you can take.